student EMT & filling out Patient Care Rep

RiderOnTheStorm · 22-07-2011 9:35am #1

hi all,
I have searched the internet, but cant find what Im looking for ... can anyone help me?

I am on an EMT course, and one OSCE is how to fill out a PCR when given a scenario (eg 46yo male collapses with chest pain, no alergies, no medications, has 0 resp & 0 pulse when EMT arrives .... etc)

What I am looking for is examples of these scenarios so that I can use them to pratice filling in the PCR. Ideally I would like to have the answer too (or a copy of the PCR)

Does anyone have any? or know a site where I can get them?

stevie06 · 22-07-2011 6:20pm

Not Sure about Scenarios, but there is a Phecc Video about completing the PCR.

http://vimeo.com/22889409

TylerIE · 22-07-2011 7:53pm

Sorry if ya may have thought of it already but do you have a course text book?

If you have any of the Brady books (and many others) they often give case studies in the text - use the information in them to fill in your PCR - its not always possible to get all the information so occasionally you may have areas which are "Unknown" e.g. AMPLE history... Also many of the US textbooks have great sections on documentation, as there is no standardised national PRF / PCR so it gives good generic advice.

maglite · 22-07-2011 10:33pm

You looking for a story to fill in a PCR from,

or a PCR for a given story?

one2one · 22-07-2011 10:45pm

I'd say its a story to fill in the PCR, as the OHCA section often catches you out.

RiderOnTheStorm · 25-07-2011 10:33am

lst wrote: »

Sorry if ya may have thought of it already but do you have a course text book?

aaahh .... actually , I didnt think of that .... I will dig it out and see . I knew it was a good idea to ask here !!

You looking for a story to fill in a PCR from,
or a PCR for a given story?

a bit of both really. Looking for story so I can fill out a PCR form from it. But also need to know if I got it right , so need the PCR for the same story.

Hightower21 · 25-07-2011 7:48pm

Have you asked your coarse tutor? They should be able to give you a few scenarios to practice on.

Or make up your own!

e.g. 32 year old woman collapsed. RR 26, HR 130, eyes 3+ etc, her brtoher said she was feeling unwell. etc
Fill in all the details that you have on the various parts of the form.

If you dont have the details for some parts of the form then leave them blank.

Then practice, practice, practice.

Hope this helps

RiderOnTheStorm · 26-07-2011 8:57am

Hightower21 wrote: »

Have you asked your coarse tutor? They should be able to give you a few scenarios to practice on.

Or make up your own!

thx Hightower.... yes, the tutor said they have some for us to do, but we are on a 2 week break and I wanted to get some pratice in.

I could make up my own, but I would not know if I had done it right. The one PCR we filled in (from a scenario) had some stuff in it (actually stuff left out) that it would not have occured to me to do.

IE, scenario: a patient was DOA when EMT arrives , resp zero and pulse zero. It was not on the scenario that the EMT did a CAP refil, but we were told to fill in >2 on CAP Refil . Also, we were told that there were signs of drug use. Because of this, I thought that I couldnt tell why he died, so I didnt fill out the Cardiac Arrest part of the PCR. Turns out, I should have!

If I am told A, B , and C, I can put that in the PCR no problem. Its the next step to assume / educate-guess / infer that X Y & Z also apply, is the bit that gets me.

maglite · 26-07-2011 9:29pm

RiderOnTheStorm wrote: »

I thought that I couldnt tell why he died, so I didnt fill out the Cardiac Arrest part of the PCR. Turns out, I should have!

I would be dubious in this regard. I suppose one could say all deaths are cardiac arrests but I would't like to put down anything I did't feel comfortable standing up to in court etc.

If I've a bit of spare time at the weekend I'll come up with a story or 2 if you want to fill in a PCR and we will critique it.

Hightower21 · 26-07-2011 9:59pm

If you have the information for a particular section then put it in. If you dont then leave it blank. simple.
Remember some info gets put in twice. eg HR 0 RR 0 would go in 3 times. in in inital patient assessment, in vital signs and on the back in OHCA section. dont worry about leaving blanks. after all you are not expected to make it up. only go by the information they have given you.

Dont assume anything. assumptions is the mother of all FU$K Ups!

RiderOnTheStorm · 27-07-2011 1:31pm

maglite wrote: »

If I've a bit of spare time at the weekend I'll come up with a story or 2 if you want to fill in a PCR and we will critique it.

thx maglite , that would be great !

Hightower.... I hear ya ... but exactly as you say, all deaths are cardiac arrest ... but they may be caused by other issues or just unknown.

maglite · 30-07-2011 1:03pm

OK,

SO your at an Event helping out your local VOL group. Your Amb call sign is EMS09. The crew is yourself and one EFR(1233 pin) Your Pin is 1234.

The time and date of the event is that of this post. When the following incident happens. http://www.youtube.com/watch?v=6xh0V_K0_Mg&NR=1

It takes Rally Rescue about 5 min to clear you to go onto the course. As you arrive you take over from the Rally Rescue EFR and begin working your magic. THe passenger has self extricated and refuses your treatment opting to be checked over by the course Doc. However the Driver is still in the car and appears to be in some degree of pain (8). You ask how the day is going and he is able to recite the event in detail, describing his mistake without any physical exertion.

He is complaining of pain in his lower back and shoulders and left arm. At this point Rally Rescue express a desire to start cutting things up to get ht e driver out. ( This will take 25min. for Extrication). The notable points on a SAMPLE history include " Some Nitrate yoke after my Heart operation"

Initial Obs
Incident +9min
Pulse- 88
Resp-18
Sp02-96
BP-130/90
CapRef- <2
Eyes- 4+4+
GCS- 15
Pain- 8
BGL 8
ECG NSR@87

You Extricate package appropriately and transport to XUH Incident +40min. The journey time is about 30min, wait to be seem 5min, And your good to go with all your equipment another 15 min after that.

Drugs at your discretion and as appropriate. Driver is Paul Watts, normally resident in 13 High Court Villas, Berghaus Lane, Dublin, he is a 48yo male born, 12th Aug, and his wife's name is Betty.

If you need any other info ask.

sgthighway · 30-07-2011 5:50pm

@maglite
Fair play to you for taking time to put this together.

RiderOnTheStorm · 09-08-2011 1:54pm

thx maglite .... thats perfect .... I appreciate it.

I will do this as homework this evening and have an attempt at an answer (PCR) tomorrow

Sorry for slow response. I was on holidays .... a whole week off! (rest of holidays spent doing the EMT course)

miju · 10-08-2011 10:02am

RiderOnTheStorm wrote: »

It was not on the scenario that the EMT did a CAP refil, but we were told to fill in >2 on CAP Refil .

But you can assume cap refill is >2 from the simple fact patient has no pulse. Without a beating heart how is blood going to circulate?

Hightower21 · 10-08-2011 4:21pm

If its not done or mentioned then do not put it down. Only put information if it is mentioned.

Mycroft H · 10-08-2011 5:13pm

Hightower21 wrote: »

If its not done or mentioned then do not put it down. Only put information if it is mentioned.

But also remember to put down everything that was carried out when treating a casualty.

If its not recorded it looks like it wasn't done!

miju · 11-08-2011 12:05pm

Hightower21 wrote: »

If its not done or mentioned then do not put it down. Only put information if it is mentioned.

So are you saying if it's not mentioned that no cap refill was taken yet the patient has no pulse you leave that section of the PCR blank regarding cap refill ?

murf313 · 11-08-2011 5:03pm

miju wrote: »

So are you saying if it's not mentioned that no cap refill was taken yet the patient has no pulse you leave that section of the PCR blank regarding cap refill ?

If the patient has no pulse the last the thing you need to worry about is their cap-refill

miju · 11-08-2011 7:45pm

murf313 wrote: »

If the patient has no pulse the last the thing you need to worry about is their cap-refill

well thats obvious but we're talking about an OSCE not a real life scenario :rolleyes:

blondie7 · 12-08-2011 8:48am

Hightower21 wrote: »

If you dont have the details for some parts of the form then leave them blank.

God PHECC would love to hear you saying that :rolleyes:

civdef · 12-08-2011 9:20am

Would they prefer that fields be filled up with imaginary information?

murf313 · 12-08-2011 11:28am

miju wrote: »

well thats obvious but we're talking about an OSCE not a real life scenario :rolleyes:

i think your sarcasm detector may be broken :rolleyes::rolleyes:

Anyway, if you didnt check the cap refill time then dont record on the prf that you did. If your patient has no pulse then chances they are in cardiac arrest so you are hardly going to be worrying about cap refill times. If you didnt do it, dont record that you did!!!

miju · 12-08-2011 12:03pm

murf313 wrote: »

Anyway, if you didnt check the cap refill time then dont record on the prf that you did. If your patient has no pulse then chances they are in cardiac arrest so you are hardly going to be worrying about cap refill times. If you didnt do it, dont record that you did!!!

Yes in real life, but in an OSCE scenario which is what we're talking about you will need to fill it in off that I'm 100% certain given what we've been told and by whome on our EMT course.

Don't tick the box your one less away from your 80% mark to pass the OSCE

civdef wrote: »

Would they prefer that fields be filled up with imaginary information?

Except it's not imaginary. No pulse = no circulation = cap refil >2

Hightower21 · 15-08-2011 8:42pm

miju wrote: »

Yes in real life, but in an OSCE scenario which is what we're talking about you will need to fill it in off that I'm 100% certain given what we've been told and by whome on our EMT course.

Don't tick the box your one less away from your 80% mark to pass the OSCE

Except it's not imaginary. No pulse = no circulation = cap refil >2

Was cap refill checked?
Yes - insert details
No - Leave it blank.

This applys to Real life and OSCEs

As an emt or above we do not make up details. we do document everthing that was done. as mentioned before if it is a cardiac arrest then there will be no cap refill.

Hooch · 15-08-2011 8:49pm

Hightower21 wrote: »

as mentioned before if it is a cardiac arrest then there will be no cap refill.

Sorry...er.....what??

Hightower21 · 15-08-2011 8:55pm

NGA wrote: »

Sorry...er.....what??

Dont fully understand the question?

Hooch · 15-08-2011 8:58pm

Hightower21 wrote: »

Dont fully understand the question?

You are saying if a patient is in arrest then they have no cap refill....is that correct??

Hightower21 · 15-08-2011 9:02pm

NGA wrote: »

You are saying if a patient is in arrest then they have no cap refill....is that correct??

If it is witnessened then yes - however you will not be worried about that,
If it is not witnessed, (after some time) then no.

Hooch · 15-08-2011 9:03pm

Hightower21 wrote: »

If it is witnessened then yes - however you will not be worried about that,
If it is not witnessed, (after some time) then no.

May I ask are you a practitioner???

Hightower21 · 15-08-2011 9:05pm

NGA wrote: »

May I ask are you a practitioner???

yes. Paramedic

murf313 · 15-08-2011 10:36pm

The point i was trying to make here is, if the patient is in cardiac arrest then you will not have time to take a cap refill time. Therefore you will leave that section of the pcr blank as you did not physically do this check. It would be like filling the bm section in when you didnt take a blood glucose. But at the end of the day if your instructors are telling you to fill it in then i suppose you should do it.
However i as a practitioner would not do it.

one2one · 02-10-2011 9:52pm

Hightower21 wrote: »

If it is witnessened then yes - however you will not be worried about that,
If it is not witnessed, (after some time) then no.

Would they not have a cap refill of >2?

mr.dunkey · 03-10-2011 3:11pm

If you have more than 5% of a pcr filled out at a cardaic arrest theres something wrong. pen to paper is the last thing that will be happening:eek:

Hightower21 · 03-10-2011 8:15pm

murf313 wrote: »

The point i was trying to make here is, if the patient is in cardiac arrest then you will not have time to take a cap refill time. Therefore you will leave that section of the pcr blank as you did not physically do this check. It would be like filling the bm section in when you didnt take a blood glucose. But at the end of the day if your instructors are telling you to fill it in then i suppose you should do it.
However i as a practitioner would not do it.

My point is that if your sceneario states that there is a Cap Refill of less than 2 sec then put it down. If they didnt give it then dont put it down.

You only ever put down the information you are given. (or on the road the information you get)

student EMT & filling out Patient Care Rep

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